Electronic Fetal Heart Rate Monitor

Electronic fetal monitoring (EFM) is a diagnostic procedure studying the behavior of the fetal heart rate in relation to fetal movements and uterine dynamics. The evaluation of fetal heart rate was first described. Once in “The History in fetal monitory” where he says “in the seventeenth century FHR was heard by Phillipe Le Gaustad who described in a poem “The auscultation of the heartbeat ensures diagnosis of fetal life”.

The electronic assessment of fetal heart has its beginning in 1906 when first reported Cremer printing fetal electrocardiogram, since numerous reports have appeared. Fetal electrocardiogram in the medical literature and has long been used to diagnosis of fetal life. Hon 1958 is reported using an electronic technique evaluation of electronic fetal heart rate monitor instantly from the beginning of the first period of delivery to the expulsion of the fetus as it considered a difficult diagnosis fetal distress with intermittent auscultation, so he concluded that the use of a modern electronic technique that allows assessing changes in frequency. Fetal heart rate throughout labor and ensure accurate assessment of the distress fetal. Hon was who introduced the concept of instantaneous fetal heart rate and its variations.

The first paper describing the clinical application of Electronic Monitoring of Fetal Heart Rate was Paul and Hon (1975 which described their experiences with 6% of 4561 deliveries performed at Yale New Haven Hospital where concluded that electronic monitoring was beneficial in complicated pregnancies.

By 1978 it was estimated that about two thirds of women U.S. were electronically monitored during labor. In 1993, 639 women, comprising 78% of all live births had been subjected to electronic fetal monitoring.

While it is true that electronic fetal monitoring is used in Women at High Risk Obstetric and are especially good perinatal outcomes that achieves the objective of reducing perinatal morbidity, but used in Low Risk Obstetric pregnancies they only increase significantly incidence of caesarean section without showing the improved results of Perinatal damage. Of course these are demonstrated in randomized controlled trials and these are not the number of cases conclusions appropriate to give the benefit of electronic fetal monitoring in pregnancies low risk. It is important to note that in the 80 ‘in the United States Monitoring Electronic Fetal increased disproportionately more on low-risk pregnancies Obstetric 46.5 to 76.3%.

It has attributed much of the decline in mortality perinatal to the introduction of electronic fetal monitoring until 1969 rates are reported perinatal mortality of about 50% and from the widespread use of Electronic fetal monitoring in 1974 fell to 21%. In a study conducted in 1975 by Tutera and Newman show Perinatal Mortality in a group of women Medium Risk is monitored from 8 per 1,000 live births compared to another group that was not monitored, which was 19 per 1,000 live births. Then, the reduction of perinatal mortality is one of the most important developments in obstetrics, in relation to the use of Monitoring Electronic Fetal.

Electronic fetal monitoring is an important practice obstetric. During a 1980 study reported an incidence of Caesarean sections was significantly increased, so much so that in 1968 was 4.5% vs.12.5% in 1975 and approximately 15 to 20% in 1980. From studies depth was observed an increased frequency of caesarean sections from the beginning of Electronic Fetal Monitoring.